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Ashley Smith given five injections of drugs in seven hours at Quebec prison, inquest told

Ashley Smith received five injections of powerful drugs — including anti-psychotics — in less than seven hours while restrained in a bed at Joliette prison in Quebec in 2007.

Melanie Boucher, who was a registered nurse at Joliette prison in Quebec, gave Ashley Smith four of the five drug injections she received July 22, 2007.
(Donovan Vincent / Toronto Star) | Order this photo

Ashley Smith received five injections of powerful drugs — including anti-psychotics — in less than seven hours while restrained in a bed at Joliette prison in Quebec in the summer of 2007.

Jurors in the Toronto inquest into the teen’s death watched dramatic video of the incident that started with Smith, 19, being taken from her segregation cell by several emergency response unit guards, who were dressed in protective gear.

Melanie Boucher, then a registered nurse at the prison, told the inquest Wednesday that she was the individual who gave Smith four of the injections on July 22, 2007. Boucher said she administered the drugs under direction she received by phone from Dr. Michele Roy, a psychiatrist.

Smith was injected four times between 1:09 p.m. and 3:31 p.m. that day. Among the drugs she received were the anti-psychotics Clopixol and Haldol, and anti-anxiety medication Ativan. What the inquest hasn’t seen yet, but what has been released in a public document looking into Smith’s treatment at Joliette, is that at 7:57 p.m. that day another nurse injected Ashley while she was still restrained in the bed.

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Boucher told the inquest that she received information from Joliette staff that Smith had put a piece of metal from the wall of her cell into one of her body cavities.

Blood was spotted on the floor of Smith’s cell and the front of her anti-suicide gown was bloodied. An evaluation of Ashley while she was in her cell determined she was breathing normally and her life didn’t seem to be in danger, Boucher testified.

Boucher said Dr. Roy and the head nurse were informed of the situation, and Roy prescribed physical and chemical restraints. There was a fear Smith could harm herself or others with the metal she’d hidden, the inquest heard.

After being taken out of her cell by prison guards, Smith showers, and is seen on the video being escorted by the emergency team, arms cuffed behind her, to another room where she’s strapped into the special bed by her arms and feet, wearing a clean gown.

That’s when she starts getting the medications. The first injection is a slow-acting, longer-lasting mixture, while the second is quicker, the inquest heard.

The video is noisy, with Ashley constantly shouting “you’re hurting me,” and “get off me’’ as the guards restrain her. The guards and Boucher repeatedly tell her to calm down and stop trying to get out of the restraints.

Boucher said Ashley continued to be agitated despite the injections — the video shows Smith struggling at times, and the guards often use force to get her to lie down when Ashley sits up — and Boucher told the inquest that’s why the injections were repeated.

“I don’t want to lie down,’’ Smith yells at the guards at one point.

“We’ll give you some more medications, is that what you want?’’ a woman in the room asks Smith before the second injection.

“No’’ Smith replies.

The goal set out by the psychiatrist Dr. Roy was to get Smith calm enough that she could be transported to a hospital, Boucher testified.

Coroner’s counsel Marg Creal asked Boucher if she had any concerns after giving Ashley the second injection.

“Our concerns were we couldn’t stabilize her sufficiently for the trip to the hospital,’’ Boucher replied.

“We wanted to stop the restraint measures and put her back in her cell, but she was still agitated,’’ Boucher said, later adding if Ashley had demonstrated 45 minutes of calm and cooperation instead of the “feverish’’ state, she could have been put into an ambulance.

During a break Wednesday, Richard Macklin, a lawyer at the inquest representing Ontario’s child and youth advocate, said in an interview the video raises “grave concerns’’ around the issue of Ashley’s consent to the “extraordinary’’ injections.

“There’s a flurry of ‘no’ ‘no’ ‘no’ (by Ashley) and to infer a ‘yes’ in any of that would be a stretch,’’ the lawyer added.

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